NPI | 1124504675 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 8877) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 8877) |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2018-07-18 |
Last Update Date | 2024-04-26 |